When to Expect Accutane to Start Working?

Question

I just started Accutane and I was wondering when I should expect it to start working. Also, are there any preventative things I can do while I'm on it.

Jason Emer, MD · Answer

Isotretinion takes 20+ weeks to fully work, its all dependent on the total dose used.  Most people see results in 6-8 weeks after starting and will see a flare of the acne at the beginning.  I have my patients do light chemical peels and skin care/facials during therapy.  If they have acne scars and facial redness, ill use pulsed dye laser and microneedling for improvement.  Best, Dr. Emer.

Sonia Badreshia-Bansal, MD · Answer

The first month on Isotretinoin can be challenging. Things often get worse before they start to get better. By the end of the second month there are usually no new breakouts and patients more often complain about redness & dryness than new pimples or painful cysts.

Kally Papantoniou, MD, FAAD · Answer

Accutane will usually start to work within the first 1-2 months, but some patients will actually worsen during this initial phase, and this is normal too. Each patient will have a different experience, and very few patients are still breaking out towards the end of their treatment. When a patient is still experiencing breakouts there are few options to what can be done: we can finish the 6 months, take a 3 month break, then resume another course, or we can extend the treatment beyond the 6 months (and this is dependent on you Doctor's clinical judgement), and we can consider other reasons for why a break out is still occurring, we should consider a hormonal component if the patient is female which can also be treated successfully.While on Accutane, I would only use gentle facial cleansers, avoid using any acne topical therapies, avoid supplemental Vitamin A, and use sun protection daily, and do not forget to use a good lip balm several times per day.Good luck, Dr. P.

Daniel Navi, MD, FAAD · Answer

In the first month of treatment on Accutane you may notice a worsening of acne. This is expected and it's really a function of Accutane causing "epidermal and sebaceous maturation". Most patients start to notice clearing about a month after starting Accutane and it continues through the course.
As far as preventative measures: make sure to use an oil-free non-comedogenic moisturizer and sunblock everyday along with emolliating lip balm such as Aquaphor. 
Good luck!

Ingrid Trenkle, MD · Answer

Accutane or isotretinoin therapy results vary from patient to patient. Some patients will worsen before seeing any improvement, but usually within a  month or two patients will start to clear up.

Kahlil Andrews, MD · Answer

Hi Amy1956! Thanks for your question.Accutane typically takes several weeks before you start to see results. Most patients experience dryness and peeling first before their complexion starts to clear. If you are interested in using other treatments alongside Accutane, it’s best to speak with your doctor or dermatologist -- Accutane is known for making your skin very sensitive, and depending on your dosage, you may want to avoid using other treatments on your face.If you are not on a very high dose or if you are interested in seeking follow-up treatments once your round of Accutane has finished, I often recommend microneedling or platelet-rich plasma (PRP) treatments. Accutane can leave behind deep acne scars, particularly because it dries your skin and leaves it more prone to scarring. Microneedling and PRP are excellent options and highly effective in reducing the appearance of acne scars, and also can help keep your skin fresh and healthy to prevent acne or breakouts from returning. Best of luck with your treatment!

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question. Most people see some initial improvement in the first few weeks to months but will have some flaring of the acne at times.   Expect very dry skin and lips.  Ask your  dermatologist about hydrating facials or light peels if you are having trouble managing the dryness.
Hope you love your results!

Zein E. Obagi, MD · Answer

Accutane does not start working immediately. In most cases, the first month your acne may be worse or may flare. After about 6 weeks is when I start seeing the major benefits from Accutane. It is important to be patient while on this medication.

Alim R. Devani, MD, FRCPC · Answer

Accutane will kick in right away to make you dry but the acne effects don't kick in till the second month. Some patients do get worse initially but this depends on the dose and the severity of their acne initially. Complete clearance doesn't usually occur till the third to fourth month in most of my patients. There is usually an 85-90% response to accutane so your chances to completely clear are excellent.

Michael A. Greenberg, MD · Answer

The answer is simple....It starts immediately.But results can take time.I have had patients who did not see major results until a few months into treatment.Everybody's course is individual.

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